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Alaska rates for HCPCS 21431

Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,236.00 / $9,774.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.64 / $3,347.91 / $3,347.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,712.37 / $2,254.82 / $3,006.77
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.64 / $3,347.91 / $4,687.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,693.35 / $2,032.02 / $4,125.18
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,575.00 / $3,426.24 / $4,336.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.64 / $3,347.91 / $4,687.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,014.24 / $3,386.40 / $4,543.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,803.86 / $3,156.76 / $3,968.49